Ethnic Identity and Past 30-Day Opioid Misuse: Mediating Effect of Relational Support

Introduction: Black Americans in Kentucky are disproportionately dying from opioid overdoses compared to other racial and ethnic groups. Despite increased mortality among this population, limited research examines factors associated with recent opioid misuse among Black adults in Kentucky. Previous literature shows that relational support and ethnic identity protect racial and ethnic minority groups from substance use behaviors, but limited research examines how these factors are associated with opioid misuse among Black adults. Grounded in Social Identity Theory, the present study examines the effect of ethnic identity on opioid misuse and the mediating effect of relational support. Method: Participants were 735 Black adults in Kentucky stratified by age and gender. Participants completed a quantitative survey examining ethnic identity, relational support, and past 30-day opioid misuse. Data were examined using PROCESS macro mediation analysis to determine the association between ethnic identity and recent opioid misuse, and whether relational support mediates this relationship. Results: While there was not a direct effect of ethnic identity on recent opioid misuse, there was a significant indirect/mediated effect. Specifically, increased ethnic identity is significantly associated with decreased past 30-day opioid misuse through increases in relational support. Conclusions: Results highlight important implications for working with Black adults who misuse opioids (e.g., in clinical substance use treatment settings) that are discussed, such as the importance of fostering strong relational supports, such as instrumental and emotional support.